Cieśluk Klaudia, Dobroch Jakub, Sawicka-Żukowska Małgorzata, Krawczuk-Rybak Maryna
Students' Scientific Group, Department of Paediatric Oncology and Haematology, Medical University of Bialystok, Poland.
Department of Paediatrics, Paediatric Oncology, and Haematology, Medical University of Bialystok, Poland.
Pediatr Endocrinol Diabetes Metab. 2018;24(4):191-196. doi: 10.5114/pedm.2018.83366.
With the increasing recognition of overweight, obesity, and metabolic diseases in paediatrics, there is a need to apply more precise diag-nostic methods to individualise the procedures and improve their monitoring. Advanced methods of evaluating body composition are a valuable addition to body weighing because they provide more precise data than screening methods such as anthropometry and bioe-lectrical impedance analysis (BIA). However, they require expensive equipment and highly trained staff. The availability of methods used in paediatrics is increasing. The article discusses the technical assumptions and summarises data from literature concerning the accuracy of chosen methods. From those, dual-energy X-ray absorptiometry (DXA) is distinguished as being widely accepted. Not only does it serve to evaluate bone density, but also to assess fat mass, making it a crucial element of multicomponent models (3C, 4C), which is often used separately as a reference method for other techniques. Methods based on body volume measurement are also of great importance. Traditionally they include hydrodensitometry (HW), which is being displaced by air displacement plethysmography (ADP), which is more acceptable among young patients. Numerous publications indicate that ADP may become a valuable alternative for widely used DXA. Isotope dilution methods are less popular in paediatrics, due to their cost and limited credibility, but are more commonly used among adults. The last group comprises imaging methods rarely used in the discussed indication. With the knowledge of available techniques and current clinical situation one can, for the patient's benefit, decide between screening and advanced techniques of body composition measurement.
随着儿科领域对超重、肥胖和代谢性疾病的认识不断提高，需要应用更精确的诊断方法来使程序个性化并加强监测。先进的身体成分评估方法是体重测量的宝贵补充，因为它们比人体测量学和生物电阻抗分析（BIA）等筛查方法能提供更精确的数据。然而，它们需要昂贵的设备和训练有素的工作人员。儿科使用的方法种类日益增多。本文讨论了技术假设，并总结了文献中有关所选方法准确性的数据。其中，双能X线吸收法（DXA）被公认为应用广泛。它不仅用于评估骨密度，还可用于评估脂肪量，使其成为多成分模型（3C、4C）的关键要素，常被单独用作其他技术的参考方法。基于身体体积测量的方法也很重要。传统上包括水下密度测量法（HW），但它正逐渐被空气置换体积描记法（ADP）所取代，后者在年轻患者中更易接受。众多出版物表明，ADP可能成为广泛使用的DXA的有价值替代方法。同位素稀释法在儿科不太受欢迎，因其成本高且可信度有限，但在成人中使用更为普遍。最后一组是在所讨论的适应症中很少使用的成像方法。了解现有技术和当前临床情况后，为了患者的利益，可以在身体成分测量的筛查和先进技术之间做出选择。
